A Qualitative Study on the Challenges of Pregnant and Postpartum Women with Opioid Use Disorder.

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OBJECTIVE: Our objective in this study was to examine the lived-experiences of four women who have received Medication-Assisted Treatment (MAT) during pregnancy. During the interviews, the women were asked a series of open-ended questions about their experience in recovery from Substance Use Disorders (SUD), predominantly Opioid Use Disorder (OUD). The interviews took place in an ambulatory clinic that cared for patients with OUD through the use of MAT and also provided patient centered educational support groups for pregnant and parenting mothers.

METHODS: 4 parenting women >1 year in treatment at an outpatient medical practice that provides MAT, primarily buprenorphine and naloxone (Suboxone). Women were video recorded during their interviews and then transcribed and analyzed. We examined trends and overarching themes that described their perceptions, preferences, and barriers that they experienced while in treatment. Secondary transcription and analysis of videos provided a basis for research that used Grounded Theory, a method of qualitative analysis. Examination of videos began with open-coding to elicit new themes and ideas throughout videos. Codes were extracted from the data, then categorized into logical groups.

RESULTS: The major themes that emerged from video transcripts were: (1) Patients’ perception of Stigma and Judgment (2) Barriers to Treatment (3) Patient/Provider roles and relationships (4) Health Education- Labor & Delivery, Pain Management, and Neonatal Abstinence Syndrome (NAS) and (5) Motivations for adherence to treatment.

CONCLUSIONS: Health education addressing the needs of pregnant and postpartum women seeking treatment is crucial in allowing the women to make informed decisions, understand treatment, and ultimately maintain recovery and achieve long-term successes. As an outcome of this study, we recommend teaching healthcare professionals and staff the consequences of stigma and judgement; proved to be treatment barriers for women receiving MAT during pregnancy.